Σφακιανάκης Αλέξανδρος
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Παρασκευή 25 Δεκεμβρίου 2015

Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition.

Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition.

Thyroid. 2015 Dec 23;

Authors: Samuels M, Kolobova I, Smeraglio A, Peters D, Purnell J, Schuff KG

Abstract
BACKGROUND: TSH-suppressive doses of levothyroxine (L-T4) have adverse effects on bone and cardiac function, but it is unclear whether metabolic function is also affected. The objective of this study was to determine whether women receiving TSH-suppressive L-T4 doses have alterations in energy expenditure or body composition.
METHODS: This study was a cross-sectional comparison among three groups of women: 26 women receiving chronic TSH-suppressive L-T4 doses, 80 women receiving chronic replacement L-T4 doses, and 16 untreated euthyroid control women. Subjects underwent measurements of resting energy expenditure (REE), substrate oxidation, and thermic effect of food by indirect calorimetry; physical activity energy expenditure by accelerometer; caloric intake by 24-hour diet recall; and body composition by dual x-ray absorptiometry.
RESULTS: REE per kilogram lean body mass in the L-T4 euthyroid women was 6% lower than the L-T4 suppressed group and 4% lower than the healthy control group (P=0.04). Free T3 levels were directly correlated with REE, and were 10% lower in the L-T4 euthyroid women compared to the other two groups (P=0.007). The groups of subjects did not differ in other measures of energy expenditure, caloric intake, or body composition.
CONCLUSIONS: L-T4 suppression therapy does not adversely affect energy expenditure or body composition in women. However, L-T4 replacement therapy is associated with a lower REE despite TSH levels within the reference range. This may be due to lower fT3 levels, suggesting relative tissue hypothyroidism may contribute to impaired energy expenditure in L-T4 therapy.

PMID: 26700485 [PubMed - as supplied by publisher]



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